Surgeon Attitudes Toward Nonphysician Screening of Low Back or Low Back-Related Leg Pain Patients Referred for Surgical Assessment A Survey of Canadian Spine Surgeons

Summary of Findings Our survey found that Canadian spine surgeons widely acknowledge ineffi ciencies in the triage timeliness of patients with low back or low back–related leg pain referred to their practices. Many surgical referrals are inappropriate, out-patient waiting times typically exceed 6 months, and most surgeons have to screen 5 to 10 patients to identify one sur-gical candidate. Most surgeons (77.6%) were interested in working with LBP clinicians to screen their patients with low back or low back–related leg pain, and we identifi ed a core set of patient history and examination items, and indicators for surgical assessment, that were endorsed by the major-ity of spine surgeons we surveyed. Most surgeons (75.3%) were willing to forgo assessment of a referred patient if surgi-cal indications were ruled out by a LBP clinician; however, fl ags” as receipt of disability benefi ts, ongoing litigation, cur-rent smoker, or high emotional stress. 15 Only 11 respondents suggested additional history components, suggesting that our list was comprehensive. Most surgeons (85.9%; 73 of 85) agreed that if the items they endorsed in the patient history could be reliably captured in an assessment by a LBP clinician, it would facilitate triaging of their patients with low back or low back–related leg pain; 8 respondents were undecided and 4 disagreed.